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Individual
LAVERNE L. JACKSON
Active
Individual
LAVERNE L. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,ICADC
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN158642
GA
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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